Abstract
Refugees are more likely than the general Western adult population to have posttraumatic stress disorder (PTSD). However, refugees face numerous barriers to accessing trauma-focused therapy. Accordingly, there is a need for novel, accessible and scalable psychological interventions. Using a multiple baseline case series (AB) design (N=7), this study investigated whether a brief cognitive intervention involving a memory reminder cue and a visuospatial task (Tetris gameplay) reduced number of intrusions of trauma in refugees with severe PTSD. Due to Covid-19 restrictions, most meetings (including intervention sessions) were delivered remotely (via video call or telephone). Participants were randomly allocated to wait one, two, or three weeks (pre-intervention phase, monitoring only; A), before starting the intervention phase (B) which comprised of five weekly sessions. Participants monitored number of intrusions (primary outcome) in a daily diary during both phases and were followed up at one and five weeks. The number of intrusions experienced during the intervention phase was compared to the number of intrusions experienced during participants’ own preceding pre-intervention phase. Four refugees experienced a reduction in number of intrusions from pre- to post-intervention. However, there were differences in the extent of the reduction, the specificity and longevity of the effect, and the broader impact on PTSD and depression symptoms, concentration, and functioning. One refugee did not experience a reduction in number of intrusions across experimental phases and two experienced an increase. This study highlighted challenges to ensuring that key components of the intervention are successfully implemented with refugees with severe PTSD and highlighted key areas for future research. Further investigations of the effectiveness of the intervention in reducing number of intrusions in refugees with severe PTSD is warranted.